Anesthesia Coding Alert

Question: One of our anesthesiologists uses xylocaine to numb the area before administering the real drug for trigger point injections or other procedures. Can this be billed separately?

Indiana Subscriber

Answer: Anesthetics like xylocaine are usually injected in the joint, trigger point or bursa to numb the pain and are considered part of the treatment injection. Heres an example of how to bill for an arthrocentesis. Bill for the procedure with code 20610* (arthrocentesis, aspiration and/or injection; major joint or bursa [e.g., shoulder, hip, knee joint, subacromial bursa]) and the injected drug code J0810 (injection, cortisone, up to 50 mg), but not the anesthetic used to numb the area before administering the real drug.

You could also bill for the syringe and needle used with code A4209 (syringe with needle, sterile 5 cc or greater, each).